{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:50:15Z","timestamp":1790880615680,"version":"4.1.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>A preoperative glenoid defect of 13.5% or larger is recognized as a subcritical glenoid defect at arthroscopic Bankart repair (ABR) for collision\/contact athletes or military personnel.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To clarify the prevalence and size of remaining bone fragments in shoulders with a subcritical glenoid defect at recurrent anterior instability and to investigate the influence on postoperative recurrence after ABR for younger competitive athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cohort study; Level of evidence, 4.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The study included 96 shoulders with recurrent instability that underwent ABR between July 2011 and March 2018 for shoulders with a subcritical glenoid defect. The patients were divided into 2 groups according to the glenoid defect size (13.5%-&lt;20%, medium; \u226520%, large). The bone fragment size in each defect group was retrospectively investigated and classified into 4 groups (no, 0%; small, &gt;0%-&lt;5%; medium, 5%-&lt;10%; large, \u226510%). The postoperative recurrence rate for each combination of glenoid defect size and bone fragment size was investigated for competitive athletes aged &lt;30 years. The fragments, when present, were repaired to the glenoid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The glenoid defect size was 13.5%-&lt;20% in 60 shoulders (medium defect group) and \u226520% in 36 shoulders (large defect group). The mean bone fragment size was 6.7% \u00b1 5.1% and 8.9% \u00b1 4.9%, respectively ( P = .042). In the medium defect group, there were 15 shoulders (25%) without a bone fragment, 6 shoulders (10%) with a small fragment, 23 shoulders (38.3%) with a medium fragment, and 16 shoulders (26.7%) with a large fragment. In the large defect group, the respective numbers were 2 shoulders (5.6%), 6 shoulders (16.7%), 14 shoulders (38.9%), and 14 shoulders (38.9%). A medium or large bone fragment was more common in the large defect group ( P = .252). Among 64 younger competitive athletes who underwent ABR with a minimum of 2 years of follow-up, postoperative recurrence was recognized in 7 of 38 (18.4%) athletes in the medium defect group, but it was not recognized in any of the 26 athletes in the large defect group ( P = .036). Postoperative recurrence was recognized in 4 of 12 (33.3%) athletes with a small fragment or no fragment and in 3 of 52 (5.8%) athletes with a medium or large fragment ( P = .019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>A larger bone fragment frequently remained in shoulders with a subcritical glenoid defect at recurrent instability. The postoperative recurrence rate after ABR for younger competitive athletes was low when a remaining larger bone fragment was repaired.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465211055707","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T13:24:29Z","timestamp":1638451469000},"page":"189-194","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Remaining Large Bone Fragment of a Bony Bankart Lesion in Shoulders With a Subcritical Glenoid Defect: Association With Recurrent Anterior Instability"],"prefix":"10.1177","volume":"50","author":[{"given":"Shigeto","family":"Nakagawa","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Sports Medicine, Yukioka Hospital, Osaka, 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